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Is there a responsibility for the United States government to either provide or ensure Universal Health Care for everyone in America?

Is it socialism to provide or ensure universal health care for all Americans? Is it a moral issue? Is it an issue of national security? Is it too expensive or can it actually save money for the American tax payer? The debate between liberals and conservatives has been extensive, divisive and has lasted for years. In the mean time, more and more Americans go uninsured including millions of children that live at or below the poverty level. How can we bailout Wall Street with $700B (including an additional $140B in pork barrel spending) and not find a small fraction of this cost to extend funding SCHIP and provide for the health of our most vulnerable citizens?

Conservative Response

But we should aim higher. What is needed is to de-shackle health care from restrictions. The government has a role, just not as intrusive a role as the new House bill dictates. The government should facilitate a nationwide infrastructure for patient information, and provide information that gives the health care system transparency. We want to see what kind of track record this doctor or that hospital has. (Remember that a conservative hero, Adam Smith, said that the free market operates justly ONLY if there is "perfect information" - that is, transparency and the rule of law.)

An unfettered market will drive prices toward affordable, once we get rid of the impediments to innovation - government interference (Medicaid/Medicare), government mandates (on businesses to provide this or that service), and insane settlements in malpractice law.

— Editor

Liberal Response

This is an issue with a clear mandate for liberals.

If our basic view is that government is the necessary entity for ensuring individual rights particularly against the moneyed interests, then health care is our issue. In the old days, there really wasn’t much difference between the prognosis for the wealthy sick and the poor sick. Today it all depends on access and technology, and that depends on money. Today, if you are wealthy you live longer. You have access to the best health care and health care technology, and you have access to the insurance that keeps your health care from bankrupting you. You can sign yourself up for the David Drew clinic, get your own personal physician, use all available medical know-how to get a complete picture of your health, and expect state-of-the-art solutions. All without missing work. If you are middle class, you may or may not have access to affordable, quality care. If you are poor, either you are without health care or you rely on Medicaid.

The key question is whether the opportunity to be healthy is reserved for those with money. We are not talking about a right to sit at the $1,000 table in Vegas, or the right to ritzy vacations, or the right to a home theatre. We are talking about whether everyone should be secure in knowing that if they get sick they will not go on the dole or drive their family into the poor house or have to wonder how they will find the care they need.

Liberals say YES we all have that right. For one thing, so many of the medical solutions to what ails us have come from government, meaning our tax dollars. NIH research, grants, tax breaks for charity, government subsidies for medical facilities, government coordination of distributing medicines - those of us who pay should have access. For another, a civilized society has to ensure the equitable distribution of some things - justice, disaster relief, and health. Government is the correct agent to make this happen.

There is another practical consideration. Those who are sick or die when they shouldn/t be sick or die - they become our problem. We pay for it somehow, through hospital ER payments to cover them, through welfare for families failed by the system, through loss of faith in what a great society should provide.

— Editor

Alternative Response

We seem to all agree on the goal: a healthier America. That demands that everyone has access to the incredible medical knowledge base and practitioners in the US today. Some have that already - those served by Medicare. And it is hard to find a Medicare patient who is complaining very much, especially since the problem of prescription drugs was largely solved under President Bush. It is also tough to find complaints from patients in Canada's single-payer system.

So the answer is simple: extend Medicare to everyone. Problem solved using a system we already have.

— Editor

NB
3/19/10

This question has been getting a lot of attention lately. It is the latest argument against the health care reform bills currently in Congress. Many have weighed in on the question; others are already threatening to take the issue to court.

Based on the Constitution’s Taxing and Spending Clause, Congress has the power to levy taxes and spend this money for the general welfare of the United States. Congress has already exercised this power in the health care industry by creating Medicare for older Americans and Medicaid for low income individuals and families and for people with certain disabilities.

Along with the Taxing and Spending Clause, those that argue that the health care reform bills are constitutional believe that Congress is covered by the Constitution’s Commerce Clause which allows Congress to regulate interstate commerce. This clause has allowed Congress to become involved in many aspects of the American economy. Obviously, health care has a huge impact on the economy - rising insurance premiums for businesses and their employees, increasing medical costs to provide medical attention to the uninsured, and personal bankruptcies resulting from excessive medical costs for those uninsured and insured. All these costs have a huge negative impact on doing business in the United States and therefore have a huge impact on interstate commerce. Congress has the power and the responsibility to reform health care.

On the other side, health care reform opponents argue that the government has never required that all Americans buy a service or product, regulated by the federal government, and is well beyond the power of Congress granted by the Commerce Clause. The Necessary and Proper Clause of the Constitution also limits the power of Congress from stepping outside the normal functions of the national government. The proposed health care reform bill is well beyond the scope of Congressional powers and it violates individual liberty.

Whether you agree or disagree with health care reform, the fact is the health care system in America is too expensive and fails millions of Americans. Even if you are young and healthy, it would be unlikely that you would avoid all health problems including those that require a visit to the emergency room. The requirement that all American people, even those that are healthy, either buy insurance or pay a tax to cover health care is needed to ensure that everyone is covered. If this part of health care reform is declared unconstitutional, health care reform will probably fail. Of course, it may be years before this issue is finally decided by the courts.

Dave H.
3/1/10

The question not asked was:

"Is Congress authorized by US citizens under the United States Constitution to legislate an individual's decision to buy, or to pay for another person's health insurance?"

Elliot S.
Madison, WI
1/19/10

"Of all the forms of inequality, injustice in health care is the most shocking and inhumane"  - Martin Luther King, Jr.

Does anyone doubt that health care was a major issue for the first year of the Obama Administration? Yet for most people the details are evasive, confusing, divisive, frustrating, elusive and difficult to comprehend.

The national health care reform debate has led to some of the most hateful, selfish, mean spirited, nasty and divisive speech this country has seen in quite a while. People have been hoodwinked or intimidated and some have been totally shut out of the debate completely, as a result.

Few people agree on what health care reform should entail, some would call it a financial drain, some call it communism, some call it a social necessity, and others would call it a moral imperative.

The case for health care might be strongest with the argument that in the present world economy we are unable to compete economically because the public sector is paying for health care coverage, because most of the world has subsidized national health care and we don't. As the argument goes unless government lifts the burden of healthcare from business, we will be unable to compete with companies in subsidized health care nations. Fear and loathing of 'socialized medicine' are leading us to no change.

Now that the House and Senate health care bills are being reconciled - both bills are hardly identical - it seems that the hope of real national health care and/or reform is lost. For this observer the health care bill seems to be more like an insurance, drug and health services company/corporation economic stimulus plan, than actual health care reform. Corporate socialism seems to be acceptable to neo-conservatives and neo-liberals, but don't let it happen for the country in general. All this decided by people who have more than adequate coverage or some of the best taxpayer provided health care in the world.

Real reform might include drug price control and reform, limits on pre-existing condition denial/pricing issues, defending and maintaining the viability of existing Medicare and Medicaid, full coverage of catastrophic conditions, pre- and postnatal care on demand for all, pain management and self medication rights, among some others.

After the last year of debate and wrangling, health care capitalism on steroids seems to be the result given the mandatory requirement that everyone purchase healthcare insurance (required by the new health care bill). Hefty fines by the Fed for not purchasing that mandatory insurance are the penalty for non-compliance. For those of us who have paid in for a lifetime and are within 10 years of receiving social security and Medicare, this is hardly a solution to a massive health care system bordering on fraud, malfeasance and greed.

Long time health care dysfunction, such as the multi level pricing schemes and excessively high drug costs, lack of catastrophic health care coverage and limits on policy pricing for pre-existing health problems are real concerns for a good deal of the country, but do not seem to be fully on the radar of those who crafted the health care bills now on the table or those others who oppose it so stridently.

The failure of the Obama Administration to start with an intention of crafting a single payer health care reform plan and then coming to a compromise would have made me happier, than starting with the intention of insurance company health care reform from the start. Flying the flag of a public option pleased only some and died on the vine early.

Have we really achieved much in the new health care paradigm? Doubtful!!! Never getting drug price reform for patients is a major failing in the health care reform effort for the invalids and elderly.

More than a few questions come to mind. Why do insurance companies pay a reduced price on drugs but the public and Medicare/Medicaid (gov't) pay full price? Drug pricing is part of what is dysfunctional about health care in this country. Why does most of the world pay less for drugs than we do? Why must someone pay for drugs twice, once to the drug company and the second time from the supplier? Why can't people go to Canada to purchase low cost drugs they need? Why a middleman in drug providing? Why do tax payers pay so much on drugs that their tax dollars helped to develop? Is extreme profiteering on health care, disease and terminal patients unethical?

After World War II the British developed a national health care system, in part because so much had been done to develop the system during the war when a huge part of the population was a refugee in their own country. It has worked well for them even with its warts. If an American becomes ill in the British Isles you will find out how well it works. They will treat you as their own. Here in this country we are not that gracious - pay up illegal... foreigner... deadbeat??!!!

In short we need to 'stop peeing in the pot we all eat from' and accept that when everyone does better everyone does better. Health care is an example where that aptly applies.

"To be without health insurance in this country means to be without access to medical care. But health is not a luxury, nor should it be the sole possession of a privileged few. We are all created b'tzelem elohim - in the image of God - and this makes each human life as precious as the next. By 'pricing out' a portion of this country's population from health care coverage, we mock the image of God and destroy the vessels of God's work."  - Rabbi Alexander Schindler, Past President, Union of American Hebrew Congregations [1992]

"Every person has the right to adequate health care. This right flows from the sanctity of human life and the dignity that belongs to all persons, who are made in the image of God . . . Our call for health care reform is rooted in the biblical call to heal the sick and to serve 'the least of these,' the priorities of justice and the principle of the common good. The existing patterns of health care in the United Sates do not meet the minimal standard of social justice and the common good."  - U.S. Catholic Bishops [1993] Resolution on Health Care Reform

"The health of a society is truly measured by the quality of its concern and care for the health of its members . . . The right of every individuals to adequate health care flows from the sanctity of human life and that dignity belongs to all human beings . . . We believe that health is a fundamental human right which has as its prerequisites social justice and equality and that it should be equally available and accessible to all."  - Imam Sa'dullah Khan, The Islamic Center of Southern California

"Health care is an essential safeguard of human life and dignity and there is an obligation for society to ensure that every person be able to realize this right."  - Joseph Cardinal Bernardin, Chicago Archdiocese

Famous Martin Luther King Quote: "Life's most urgent question is: what are you doing for others?"

NB
11/18/09

The debate over Health Care Reform has been loud, divisive, defined by misinformation and driven by political rhetoric. All this leads to more delays in providing affordable medical coverage to 47 million uninsured Americans.

So what is the solution? Conservatives claim that the private market place is the only way to solve this problem. Yet, the private insurance companies have had years and years to get it right. The insurance industry continues to fail the American people. They excessively increase premiums for individuals and businesses forcing many to drop coverage. They reject claims forcing individuals to fight for their benefits. They deny benefits to individuals with pre-existing conditions. They drop individuals who lose their jobs.

The cost of health care, even for those WITH insurance, has become the leading cause of personal bankruptcy yet the insurance industry continues to make billions in profits. They pay their CEOs and executive management tens of millions in compensation. They spend millions on lobbying Congress to block ANY Health Care Reform and to block any changes in anti-trust laws. In a free market, how can we allow the insurance industry an exemption from federal anti-trust laws?

They also spend millions misleading the American public. Many Americans now believe that Health Care Reform will result in skyrocketing premiums, long waits for medical care, health care rationing, increased unemployment, small businesses going out of business and, even worse, insurance companies going out of business.

Politicians depend heavily on rhetoric, equating health care reform to socialism or communism. And thanks to Sarah Palin, health care reform means "death panels" for the elderly and disabled. They describe the Obama Administration and the Democrats who support health care reform as Nazis. How can politicians, especially members of Congress, justify receiving "public" health care but deride a "public health care option?" Maybe if they had to experience private health care, there would be less concern for the insurance industry and more for the American consumer.

The insurance companies had their time and they failed. It’s time to reform health care - new regulations on insurance premiums and medical costs, cost controls for prescription drugs, eliminate lifetime caps on individuals, streamline medical claims to reduce administrative costs, eliminate exemptions to federal anti-trust laws, coverage for everyone including those with pre-existing conditions, coverage for those between jobs and those without a job, preventative care to keep people healthy, continued coverage for people that get sick and, most importantly, a public health care option.